Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| P30AG064198 | U.S. NIH Grant/Contract | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| National Institute on Aging (NIA) | NIH |
Not provided
Not provided
Not provided
Not provided
This study tests the feasibility of a home-based heart rate variability biofeedback (HRVB) intervention in survivors of cardiac arrest (CA). Specifically, the primary purpose of this pilot study is to assess feasibility, acceptability, appropriateness, usability, and compliance for an at-home, 3-week HRVB intervention in 10 participants. The study also tests whether cardiac-related interoceptive fear, trait anxiety, and negative affect decrease among CA survivors completing the HRVB intervention.
HRV biofeedback is a technique that combines slow paced breathing with the use of accurate, moment-to-moment physiological monitoring. The goal is to make internal cardiac information available to people in order to help them learn how to increase the beat-to-beat variability in their heart's activity and thereby increase parasympathetic activity of the autonomic nervous system. Apart from active interventions such as exercise training that reliably increase HRV but that may be inappropriate for many cardiac patients, HRV biofeedback is an easy-to-implement technique which allows people to monitor and then ultimately alter their parasympathetic activity.
Research is needed to determine whether HRV biofeedback training has beneficial consequences for mental and cardiovascular health in patients who have experienced serious, life-threatening cardiac events. The investigator believes that cardiac arrest survivors, in particular, may stand to benefit from such an intervention because many of them experience clinically significant psychological distress after their medical event.
Distressed cardiac patients may be especially motivated to learn to influence their own heart activity in order to improve their own HRV, reduce their cardiovascular risk, and lessen their symptoms of psychological distress. Therefore, it may be wise to harness this motivation in the service of helping these patients deliberately learn to alter their own autonomic activity rather than simply breathing at a rate that automatically improves HRV without any learning process. By providing patients with an external (e.g., visual) form of feedback about their otherwise largely inaccessible autonomic physiology (i.e., vagus nerve activity), the investigator will conduct a feasibility study of HRV biofeedback training with the goal of increasing HRV and reducing anxiety symptoms.
The purpose of this pilot study is to examine the feasibility of enrolling 10 participants and assessing the feasibility, acceptability, appropriateness, and usability of the at-home, multi-week HRV biofeedback training as well as participants' compliance with the intervention. Additionally, the purpose of the study is to assess whether participants generally show a decrease in cardiac-related interoceptive fear, a decrease in trait anxiety, a decrease in negative affect, and an increase in HRV during the course of the study. The data collected from participants as part of this feasibility pilot will influence the decision to continue with a larger randomized clinical trial using the methods in this pilot together with a control group. Progress will be monitored with Polar H10 heart rate monitor - a supremely precise heart rate sensor that comes with the Polar Pro chest strap. It will be used with a smartphone app Elite HRV - which is non-experimental.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention: Heart Rate Variability Biofeedback | Experimental | Participants in this intervention group complete at-home heart rate variability biofeedback (HRVB) training using a chest-worn heart rate monitor and a smartphone app. They complete at least 10 minutes per day of HRVB training on at least 5 days per week for 3 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Heart Rate Variability Biofeedback Training | Behavioral | First, participants are taught how to do relaxed, abdominal breathing. Second, they are taught how to breathe at a slow rate of 0.1 Hz (i.e., one completed breath cycle every 10 seconds). Third, they are taught how to monitor their heart rate variability (HRV) in real time using the smartphone app, which receives data wirelessly via Bluetooth from the heart rate monitor. Participants are instructed that their goal is to increase their HRV during the three weeks of at-home practice. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Eligible Cardiac Arrest (CA) Survivors Whom we Approach Who Ultimately Agree to Participate in the Pilot Study | This is to assess the feasibility of enrollment in the trial. The denominator for this metric is the number of potential participants who were approached and contacted by the study team who were determined to be eligible for the study. The numerator is the number of participants who enrolled in the study (i.e., 10 participants). | Baseline/Visit 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Enrolled Participants Who Complete the Pilot Study | This is to assess successful program adherence. | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
| Percentage of Participants Who Complete a Majority of the At-home HRVB Sessions for the Pilot Study |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Jeffrey L Birk, PhD | Columbia University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Columbia University Irving Medical Center | New York | New York | 10032 | United States |
Not provided
Not provided
Not provided
Not provided
Not provided
Ten participants consented to participate in the study. All participants were assigned to the intervention condition in this single-arm feasibility study.
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Intervention: Heart Rate Variability Biofeedback | Participants in this intervention group completed at-home heart rate variability biofeedback (HRVB) training using a wrist-worn heart rate monitor and a smartphone app. They were asked to complete at least 10 minutes per day of HRVB training on at least 5 days per week for 3 weeks. Heart Rate Variability Biofeedback Training: First, participants were taught how to do relaxed, abdominal breathing. Second, they were taught how to breathe at a slow rate of 0.1 Hz (i.e., one completed breath cycle every 10 seconds). Third, they were taught how to monitor their heart rate variability (HRV) in real time using the smartphone app, which received data wirelessly via Bluetooth from the heart rate monitor. Participants were instructed that their goal was to increase their HRV during the three weeks of at-home practice. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Intervention: Heart Rate Variability Biofeedback | Participants in this intervention group complete at-home heart rate variability biofeedback (HRVB) training using a wrist-worn heart rate monitor and a smartphone app. They complete at least 10 minutes per day of HRVB training on at least 5 days per week for 3 weeks. Heart Rate Variability Biofeedback Training: First, participants are taught how to do relaxed, abdominal breathing. Second, they are taught how to breathe at a slow rate of 0.1 Hz (i.e., one completed breath cycle every 10 seconds). Third, they are taught how to monitor their heart rate variability (HRV) in real time using the smartphone app, which receives data wirelessly via Bluetooth from the heart rate monitor. Participants are instructed that their goal is to increase their HRV during the three weeks of at-home practice. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percentage of Eligible Cardiac Arrest (CA) Survivors Whom we Approach Who Ultimately Agree to Participate in the Pilot Study | This is to assess the feasibility of enrollment in the trial. The denominator for this metric is the number of potential participants who were approached and contacted by the study team who were determined to be eligible for the study. The numerator is the number of participants who enrolled in the study (i.e., 10 participants). | The population studied for this metric was the set of all potential participants who were approached and contacted by the study team and determined to meet the eligibility criteria for the study. | Posted | Number | percentage of participants who enrolled | Baseline/Visit 1 |
|
Adverse events were assessed over the full study assessment period that lasted approximately 4 weeks total, from Visit 1 to Visit 3 of the study.
Not provided
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Intervention: Heart Rate Variability Biofeedback | Participants in this intervention group completed at-home heart rate variability biofeedback (HRVB) training using a wrist-worn heart rate monitor and a smartphone app. They were asked to complete at least 10 minutes per day of HRVB training on at least 5 days per week for 3 weeks. Heart Rate Variability Biofeedback Training: First, participants were taught how to do relaxed, abdominal breathing. Second, they were taught how to breathe at a slow rate of 0.1 Hz (i.e., one completed breath cycle every 10 seconds). Third, they were taught how to monitor their heart rate variability (HRV) in real time using the smartphone app, which received data wirelessly via Bluetooth from the heart rate monitor. Participants were instructed that their goal was to increase their HRV during the three weeks of at-home practice. |
Not provided
Not provided
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Jeffrey Birk | Columbia University Irving Medical Center | 212-342-5503 | jlb2287@cumc.columbia.edu |
Not provided
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Apr 27, 2021 | May 20, 2022 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Oct 6, 2020 | Jul 27, 2022 | SAP_001.pdf |
Not provided
| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
Not provided
Not provided
The intervention involves heart rate variability biofeedback (HRVB) administered via a smartphone app (Elite HRV) that receives real-time cardiac information from a chest-worn heart rate monitor (Polar H10).
Not provided
Not provided
Not provided
Not provided
|
|
As a measure of intervention compliance, this is to assess the percentage of participants who complete a majority (>= 8 of 15) of the at-home HRVB sessions. |
| Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
| Percentage of Participants Who Report Adequate Feasibility | This is to assess the intervention's feasibility. The percentage of participants who report scores >= 4 for the feasibility total score reflects the percentage of participants who indicated that the intervention is adequately feasible. | Post-training/Visit 3 (approximately 3 weeks) |
| Percentage of Participants Who Report Adequate Acceptability | This is to assess the intervention's acceptability. The percentage of participants who report scores >= 4 for the acceptability total score reflects the percentage of participants who indicated that the intervention is adequately acceptable. | Post-training/Visit 3 (approximately 3 weeks) |
| Percentage of Participants Who Report Adequate Appropriateness | This is to assess the intervention's appropriateness for reducing anxiety, the proportion of participants who report scores >= 4 would be adequate. This is to assess the intervention's appropriateness for reducing anxiety. The percentage of participants who report scores >= 4 for the appropriateness-for-reducing-anxiety total score reflects the percentage of participants who indicated that the intervention is adequately appropriate for reducing anxiety. | Post-training/Visit 3 (approximately 3 weeks) |
| Percentage of Participants Who Report Adequate Usability | We will assess the percentage of participants who report total scores >= 68 for their rating of the intervention's usability using the System Usability Scale. | Post-training/Visit 3 (approximately 3 weeks) |
| Visit-2-to-3 Change in Cardiac-related Interoceptive Fear | This is to assess the Visit-2-to-3 change in cardiac-related interoceptive fear measured as the within-person difference in the sum of the four cardiac-related items from the physical subscale of the Anxiety Sensitivity Index. The total score ranges from a minimum of 0 units on a scale to a maximum of 16 units on a scale. Lower scores indicate lower anxiety. | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
| Visit-2-to-3 Change in Trait Anxiety | This is to assess the Visit-2-to-3 change in trait anxiety measured as the within-person difference in the total score of the trait version of the State-Trait Anxiety Inventory. The total score ranges from a minimum of 20 units on a scale to a maximum of 80 units on a scale. Higher scores indicate higher anxiety. | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
| Visit-2-to-3 Change in Trait Negative Affect | This is to assess the Visit-2-to-3 change in trait negative affect measured as the within-person difference in the total score of the negative subscale of the Positive and Negative Affect Schedule. The total score ranges from a minimum of 10 units on a scale to a maximum of 50 units on a scale. Lower scores represent lower levels of Negative Affect. | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
| Heart Rate Variability (HRV) | This is to assess HRV using participants' exported and deidentified data from the Elite HRV smartphone app. Specifically, HRV is operationalized as the natural log of the root mean square of the successive difference (lnRMSSD), a standard measure of beat-to-beat HRV. This HRV measure is recorded for each at-home training session completed by participants using the app and the heart rate monitor. | Up to 3 weeks (starting after Visit 2 and extending until Visit 3) |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Sexual Orientation | Count of Participants | Participants |
|
| Partner Status | Count of Participants | Participants |
|
| Education | Count of Participants | Participants |
|
| Implanted Cardiac Device Type | We assessed whether participants had an implanted cardiac device. Whereas pacemakers directly influence heart rate and heart rate variability, unpaced implantable cardioverter defibrillators generally do not, and unpaced cardiac monitors do not. | Count of Participants | Participants |
|
| Beta Blocker or Antiarrhythmic Medication | We assessed whether participants were currently taking any beta-blocker medications or any antiarrhythmic medications. These medications are used to manage heart rhythm or to control blood pressure, among other uses. | Count of Participants | Participants |
|
|
|
| Secondary | Percentage of Enrolled Participants Who Complete the Pilot Study | This is to assess successful program adherence. | Posted | Number | percentage of enrolled participants | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
|
|
|
| Secondary | Percentage of Participants Who Complete a Majority of the At-home HRVB Sessions for the Pilot Study | As a measure of intervention compliance, this is to assess the percentage of participants who complete a majority (>= 8 of 15) of the at-home HRVB sessions. | Posted | Number | percentage of enrolled participants | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
|
|
|
| Secondary | Percentage of Participants Who Report Adequate Feasibility | This is to assess the intervention's feasibility. The percentage of participants who report scores >= 4 for the feasibility total score reflects the percentage of participants who indicated that the intervention is adequately feasible. | Posted | Number | percentage of enrolled participants | Post-training/Visit 3 (approximately 3 weeks) |
|
|
|
| Secondary | Percentage of Participants Who Report Adequate Acceptability | This is to assess the intervention's acceptability. The percentage of participants who report scores >= 4 for the acceptability total score reflects the percentage of participants who indicated that the intervention is adequately acceptable. | Posted | Number | percentage of enrolled participants | Post-training/Visit 3 (approximately 3 weeks) |
|
|
|
| Secondary | Percentage of Participants Who Report Adequate Appropriateness | This is to assess the intervention's appropriateness for reducing anxiety, the proportion of participants who report scores >= 4 would be adequate. This is to assess the intervention's appropriateness for reducing anxiety. The percentage of participants who report scores >= 4 for the appropriateness-for-reducing-anxiety total score reflects the percentage of participants who indicated that the intervention is adequately appropriate for reducing anxiety. | Posted | Number | percentage of enrolled participants | Post-training/Visit 3 (approximately 3 weeks) |
|
|
|
| Secondary | Percentage of Participants Who Report Adequate Usability | We will assess the percentage of participants who report total scores >= 68 for their rating of the intervention's usability using the System Usability Scale. | Posted | Number | percentage of enrolled participants | Post-training/Visit 3 (approximately 3 weeks) |
|
|
|
| Secondary | Visit-2-to-3 Change in Cardiac-related Interoceptive Fear | This is to assess the Visit-2-to-3 change in cardiac-related interoceptive fear measured as the within-person difference in the sum of the four cardiac-related items from the physical subscale of the Anxiety Sensitivity Index. The total score ranges from a minimum of 0 units on a scale to a maximum of 16 units on a scale. Lower scores indicate lower anxiety. | Posted | Mean | Standard Deviation | score on a scale | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
|
|
|
|
| Secondary | Visit-2-to-3 Change in Trait Anxiety | This is to assess the Visit-2-to-3 change in trait anxiety measured as the within-person difference in the total score of the trait version of the State-Trait Anxiety Inventory. The total score ranges from a minimum of 20 units on a scale to a maximum of 80 units on a scale. Higher scores indicate higher anxiety. | Posted | Mean | Standard Deviation | score on a scale | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
|
|
|
|
| Secondary | Visit-2-to-3 Change in Trait Negative Affect | This is to assess the Visit-2-to-3 change in trait negative affect measured as the within-person difference in the total score of the negative subscale of the Positive and Negative Affect Schedule. The total score ranges from a minimum of 10 units on a scale to a maximum of 50 units on a scale. Lower scores represent lower levels of Negative Affect. | Posted | Mean | Standard Deviation | score on a scale | Pre-training/Visit 2, Post-training/Visit 3 (approximately 3 weeks apart) |
|
|
|
|
| Secondary | Heart Rate Variability (HRV) | This is to assess HRV using participants' exported and deidentified data from the Elite HRV smartphone app. Specifically, HRV is operationalized as the natural log of the root mean square of the successive difference (lnRMSSD), a standard measure of beat-to-beat HRV. This HRV measure is recorded for each at-home training session completed by participants using the app and the heart rate monitor. | Posted | Mean | Standard Deviation | milliseconds | Up to 3 weeks (starting after Visit 2 and extending until Visit 3) |
|
|
|
|
| 0 |
| 10 |
| 0 |
| 10 |
| 0 |
| 10 |
Not provided
Not provided
Not provided